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HomeMy WebLinkAboutSASSOON, DR. MAUREEN - 2017A-2017-040 wQJ, >' CONSULTANT AGREEMENT `co THIS AGREEMENT is made and entered into this 2l't day of February, 2017 by and o � - between Dr. Maureen Sassoon, MS, MPH ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of occupational and environmental health and safety consulting services. B. Consultant represents that it is able and willing to provide such services to the City. C. The City acknowledges that it has received billing from Consultant under a previous agreement for services performed October 1, 2016 through December 31, 2016, under which the City exhausted all funds provided for in the agreement. City intends that any unpaid sums owed to Consultant for prior services provided October 1, 2016 through December 31, 2016, shall be covered under this Agreement. The previous agreement with the Consultant terminated sooner than expected due to unanticipated demands for the Consultant's services which resulted in increased expenses. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional in the same field. NOW TI3ERE,FORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services relating to occupational and environmental health and safety consulting services including but not limited to those services set forth in. Exhibit "A", attached hereto and incorporated herein by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identi lied in. Exhibit B. The total sum to be expended under this Agreement, shall not exceed $75,000.00 during the term of this Agreement. b. City acknowledges that agreement includes payment for services rendered October 1, 2016 through December 31, 2016. c. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on rune 30, 2018, unless terminated earlier pursuant to Section 12, below. The term of this Agreement may be extended upon a writing executed by the City Manager and the City Attorney for up to one (1) year. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to its employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance which shall include, but not be limited to protection against claims arising fiom bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence and 52,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); and (b) be primary and not contributory with respect to insurance or self-insurance programs maintained by the City. b. Worker's Compensation Insurance. In accordance with California State law, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of 2 the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. c. Professional Liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim and $2,000,000 annual aggregate shall be maintained. d. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period coveredby this Agreement. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City. (ii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. (iii) If the Consultant maintains broader coverage and/or higher limits than the minimums described above, the City requires and. shall be entitled to the broader coverage and/or higher limits maintained by the Consultant. e. if Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6, INDEMNIFICATION Consultant agrees to and shall. indemnify, defend, and hold harmless the City, its officers, agents, employees, consultants, counsel, and representatives from liability for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims; (l) for personal injury, including death, and claims for property damage, arising from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in Section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of effects arising from this Agreement. This indemnity and hold. harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section. The Consultant further agrees to indemnify, hold harmless, w -id pay all costs for the defense of the City, including fees and costs for counsel to be selected by the City, regarding any action by a third party asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may mare all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Consultant received from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant and disclosed without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by facsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, California 92702-1988 Facsimile (714) 647-6956 Copies to: Executive Director of Personnel Services City of Santa Ana 20 Civic Center Plaza (M-24) 4 To Consultant: P.O. Box 1988 Santa Ana, California 92702 Facsimile (714) 647-5311 City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702-1988 Facsimile (714) 647-6515 Dr. Maureen Sassoon, MS, MPH P.O. Box 2028 Palos Verdes Peninsula, CA 90274 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the :new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid., and addressed as set forth above. If sent by facsimile, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and. any attachments hereto, the terms of this Agreement shall prevail and will serve to fully supersede existing Agreement. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms or conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended. to secure the specializedservices of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City with thirty (30) days written notice of termination to the Consultant. a. As a condition of such payment, the City may require Consultant to deliver to the City all the work product completed as of such date, and. in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work that fails to meet the standard of performance specified in the Recitals of this Agreement. 13. NON DISCRIMINATION Consultant shall not discriminate because of race, color, creed, relation, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion., termination or other employment related activities or any activities under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United Sates, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: (—m- 1N 111'4v MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: LAURA ROSSINI Senior Assistant City Attorney RECOMMENDED FOR APPROVAL: ED ARD RAYA Executive Director Personnel Services Agency CITY OF SANTA ANA GERARDO MOUET Acting City Manager CONSULTANT DR. MAUREEN SASSOON, MS, MPH. Sole Proprietor EXHIBIT A Sca a of Services Provided b Dr. Maureen Sassoon CIH to the Ciy of Santa Ana 1. Conducting the City Safety Committee Meetings, pursuant to the City's Injury, Illness Prevention program (IIPP), approximately six times per year. 2. Employee Health & Safety Training (i.e., Cal -OSHA mandated training) for City employees covering such topics as respiratory protection, hearing conservation, emergency action/fire response, hazard communication, hazardous waste, confined space, lockout/block out, supervisor safety inspections and accident investigations and hands-on defensive driving on private property. 3. Inspection services as needed by a Certified Asbestos Consultant, per the State of California. 4. Inspection services as needed from a Lead -Certified California Department of Public Health Consultant. S. A City -Wide Safety Inspection, 6. Advising the City and if necessary participating in representing the City's interests in issues involving Cal -OSHA. 7. Other third -party health and safety services on an as needed/required basis (i.e., employee work station ergonomic evaluations, indoor air quality surveys and noise surveys) as requested by Risk Management and/or Human Resources. S. Conduct an audit of the existing loss control programs with recommendations for changes, as deemed necessary. 9. Other tasks as requested by the Executive Director of Personnel Services or her designee. EXHIBIT B FEE AGREEMENT FOR OCCUPATIONAL & ENVIRONMENTAL HEALTH & SAFETY CONSULTING SERVICES For the CITY of SANTA ANA DR. MAUREEN SASSOON, MS, MPH 3101544-2912 Certified Industrial Hygiene Fees: 1. General industrial hygiene services (excluding legal cases) are charged at a rate of $150/hour, portal-to-portal, with a 4 -hour minimum. Additional charges, such as but not limited to: equipment and laboratory fees, printing and duplicating fees, data base fees (i.e., such as are associated with Phase I research), and travel related fees (i.e,, airfare, hotel, car rental) are charged to the client per associated incurred cost, if the client pays them direct or up front, otherwise there is a 10% mark-up. Invoices are submitted monthly, for services rendered, and are expected to be paid in -full, within 30 days of the invoice date. Account balances not paid within 30 days are subject to a 1.5% monthly service charge, on the remaining balance. 2. General office work, report writing and research are charged at $150/hour. 3. Legal Cases, including preparation, document review, research, industrial hygiene surveys and all other related work including Court time (with or without testimony) and Depositions are charged at a rate of $450/hour, with a 4-11our minimum, plus expenses if outside the greater Los Angeles area. 4. Deposition and Court fees are due at the beginning of each day. If you agree to these terms and conditions, please sign and date at the bottom and reply by USPS to Dr. Maureen Sassoon at PO Box 2028, PVP, CA 90274. Company: (Signature) Title (Print Name) (Effective: January 2016) Date DRMAU-1 0P iD: GB � �e©° CERTIFICATE OF LIABILITY INSURANCE kft�06/1712016 FDATE cMMroDYYYY} THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Brakke Schafnitz Ins. Brokers Licence #OK07568 100 Wilshire Blvd. #940 NAMTACT Carole S. Mitchell PHONE -1357 c No : 949-313-3323 E-MAILS carole.mltChell si .us Santa Monica, CA e0401 Daria Gray INSURE 5 APFORRDING COVERAGE NAIL 0 INSURER A. Westchester Surplus Lines Ins '"* INSURED Dr. Maureen Sassoon P 0 Box 2028 Palos Verdes Peninsula, CA 90274 INSURER 6: INSURER C: EACH OCCURRENCE $ 1,000,000 INSURER D INSURER E CLAIM5-MADE OCCUR L.:---.! INSURER F X CQ"1c Ae-E-S CERTIFICATE NUMBER: 1 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED Br=LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE D R POLICY NUMBER P PA PO>-ICYEXP MMIDO LIMITS A X COMMERCIAL GENERAL LIABILITY '"* EACH OCCURRENCE $ 1,000,000 CLAIM5-MADE OCCUR L.:---.! X X G24270427005 0710112016 07101!2017 PREMISES(Ica occrrenne $ 50,000 MED EXP (Anyone person) $ 5,00 X Add'I Insured X Prof&Pollut-CLM PERSONAL &AOVINJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,00 PRODUCTS-COMPlOPAGG $ 2,000,000 X POLICY PEO LRC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANYAUTO BODILY INJURY (Nr accident) $ AAILLL,OOWNED SCHEDULED AUTOS NON -OWNED HIREDAUTOS AUTOS � OPEdRdTYt AMAGE $ a UMBRELLA LIAIS EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB �CO)CCUR D]EL7 RETENTIONPER $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY FROPRIETORIPARTN£RIEXECUTIVE ❑N!A OFFICERIMEMBER EXCLUDED? (Mandatory in NH) ITTH- ST UTE ER E.L. EACH ACCIDENT $ EL -DISEASE -VA EMPLOYEd $ E.L.DISE45E-POLICYLIMrf $ Ifyas,desurl6aunder DESCRIPTIO PERA7I0NS below A Professional Liab. G24270427005 07/0112016 07101/2017 Prof.Liab 11000,00 A Contractors Poli, G24270427006 07101/2016 07/0112017 Pollution 1,000,00 DESCRIPTION OF OPERATIONW LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space fa raqulrad) Policy Provides 30 days notice of cancellation except 10 days for nonpayment Applicable Endorsements Attached where required by Written Contract mailed to: SMoralesS@santa-ana.org CERTIFICATE HOLDER CANCELLATION CSANTAA SHOULD ANY OF THE ASOVIr DESCRIBM POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cif of Santa Ana Y ACCORDANCE WITH THE POLICY PROVISIONS. Attn: BrIza Morales,Risk Mngr P.O. Box 1988 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 '"* @ 1988-2014 ACORI) CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD �� 0 Named Insured Endorsement hiumber Dr. Maureen Sassoon Policy Symbol Policy Number Elfective Date of Endorsement ECP =07/0'112016to07/01/2097 0710112016 Issued 9y (Name of Insurance Company) WastcheSter Surplus Lines Insurance Company Insert tiro popsy number. The remainder pf the Information is W be 6ompteted only when this endorsement is issued subsequent tD the preparation & the policy. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NOWCONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no erAry aramears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) SECTION 11 -WHO IS AN INSURED is amended to include: A. SECTION 11 - WHO IS AN INSURED is amended to include as an insured the person or organization shown In the Schedule, but only with respect to liability arising out of your ongoing operations perforated for that Insured_ B. With respect to the Insurance: afforded to these additional insureds, the following exclusion is added, 2. Exclusions This insurance does not apply to bodily Injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or an behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That partisan Qf your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The C=overage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV -3101 (08-04) Includes copyrighted material of Insumnce Services (office, Inc. with its permission Page 1 of 1 Named Insured Endarsemont Number Dr. Maureen Sassoon Pollry Symbol Policy Number Policy period Effective Date 7 Endorsement EGP 1 1 07101/2016 to 07/01/2017 07/0112016 Issued By (Name of Insurance Company) Westchester Surplus Lines insurance Company Insertthe polIGV number. The remainders€ the information to lobe complated Only when this endorsement is issued uubwqumlt to the pralwrnHon of tris policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE NISMS of tie rson or Organization, Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are perForming operations, and only at the specific written request of such person or organization to you, wherein such request Is made prier to commencement of operations. (if no entry appears above, information required W complete znis enQQrseM8nL Will vr5 bnuw,I [„ uin uCLra1auU1/a as OppE.,,aU1G av u endorsement_) The TRANSFER OF RIGHT'S OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above beoausa of payments we make for injury or damage arising out of your ongoing Operations or your work done under a contract with that person or organization and included in the products -completed operatlons hazard. This waiver applies only to the person or organization shown In the Schedule above. All other terms and conditions remain the same, A3 ENV -3143 (03-05) Includes capyrigNed MWed3l of InSvranGa Services Office, Ins. with its permission Page f of 1 ?_% " DRMAU-1 OP ID: C6 o. CERTIFICATE OF LIABILITY INSURANCE '4� OATE(M1120 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 05139!20 77 7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Carole S. Mitchell Brakke Schafnitz Ins. Brokers License #OK07568 a7° .310-524-1357 A No :I49-313-3323 SantaWilshire Blvd. # 700 Sanaa Monica, CA 90401 ADDRESS: Carole. mitchell@sig.us INSURER(S) AFFORDING COVERAGE MAIC # Darla Gray INSURERA:Westchester Surplus Lines Ins urrene $ 50,000 PREMISES Ea occcc INSURED Dr. Maureen Sassoon P O BOX 2028 INSURERB: Palos Verdes Peninsula, CA 90274 INSURERC: INSURER D: PERSONAL&ADVINJURY $ 1,000,00 INSURER E: GENERAL AGGREGATE $ 2,000,00 INSURER F: L.LJVVKAL,r_, I_Fw I1FIf .-LIF NI lmmFw. 9 MR1101/ kl L111RaOCO. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !POLICY LTR TYPE OF INSURANCE IND WVD POLICY NUMBER MMIDDY EFF EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR X Add'Ilnsured X X 624270427005 07!0112017 07/01/2018 EACH OCCURRENCE $ 1,000,000. urrene $ 50,000 PREMISES Ea occcc MED EXP (Any one person) $ 5,000 X Prof & Pollut-CLM PERSONAL&ADVINJURY $ 1,000,00 GEN'LAGGREGATE LIMITAPPLIESPER X POLICY ❑ JecT ElLOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Perperson) $ ANY AUTO ALL OWNED SCHEDULEp AUTOS AUTOS BODILY INJURY Per accident $ ( ) NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE PeraccideM $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ ................. (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Professional L)ab. G24270427005 07101/2017 07/01/2018 Prof.Liab 1,000,00 A Contractors Poll. 624270427005 07/01/2017 07/01/2018 Pollution 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Policy Provides 30 days notice of cancellation except 10 days for nonpayment Applicable Endorsements Attached are Applicable where required by Written Contract. Emailed to: SMorales5@santa-ana.org 111111161z CSANTAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Briza Morales,Risk Mngr P.O. BOX 19$$ REPRESENTATIVE= Santa Ana, CA 92702 AUTHORIZED REPRES� ©1988-2014 ACORD CORPORATION. All rig isr served. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD q P Named Insured Dr. Maureen Sassoon Endorsement Number Policy Symbd Poky Number Poky Period Effective pate of Endorsement ECP 624270427 006 07/0112017 to 07/0112018 0710112017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number_ The remalnder of the Information is to be completed only when this endorsesneni is issued subsequent to the preparation ofthe poricy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the neniarafinm nG applicable to this endorsement.) SECTION II - WHO IS AN INSURED is amended to include: A. SECTION 11 - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added.- 2. dded: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV -3101 (08-04) Includes copyrighted mterial of Insurance Services Office, Inc. with its perp fission V�\V Page i of 1 Named Insured ErtdomementNumbar Dr. Maureen Sassoon Policy Symbol Policy Number Policy Period Et7 CUve Date oiadorsement ECP I G24270427 006 07101!20'17 to 07101/2018 0710112017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the lnfaratatlon Is to be completed only when this andorsement is issued subsequent to the preparation ofthe policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEWNT OWNERS, LESSEES OR CONTRACTORS—SCHEDULED PERSON OR ORGANIZATION This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ENV -3100 (08-04) Includes copyrighted materia[ of insurance Services Office, Inc. with its permission Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number Dr. Maureen Sassoon policy Symbol Polity Number Policy Period Effective Date of Endorsement ECP 624270427 006 07101/2017 to 07/0112018 07101/2017 Issued By (Name of Insurance Company) Westchester Surplus Unes Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PRO IDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organi?ation that is an owner of real property or personal property on which you are perfom-ing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and "included in the products -completed operations hazard. All other terms and conditions remain the sauce. ENV --0220 (10-08) Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED, OPERATIONS HAZARD PRIMARY & NON-CONTRIBUTORY Named Insured Endorsement Number Br. Maureen Sassoon Policy Symbol Policy Number Policy Period Effective Date of Endorsament ECP 624270427 006 07/01/2017 to 07101/2018 07101/2017 Issued By (Name of Insurance company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOV41NG: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement_) Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products -completed operations hazard. Furthermore, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. All other terms and conditions remain the same. ENV -3226 (10-08) V4�� Page 1 of 1 Named Insured Endorsement Number Dr. Maureen Sassoon Policy Symbol Policy Number Policy Period Effective nate of Endorsement ECP 624270427 006 0710112017 to 07/01/2018 07101/2017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder ofthe information is to be completed only whenthis endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL. LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PANT SCHEDULE Name of Person or O anization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations, i s IIW L711LIy aPNea1a :aUUVe, mioirrration requirea to complete tnls endorsement will be shown in the Declarabons as applicable to this endorsement) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condlf'ton is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in tate products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV -3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. uvith its permission t IV Page I of 1 DRMAU-1 OP ID: C6 o. CERTIFICATE OF LIABILITY INSURANCE '4� OATE(M1120 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 05139!20 77 7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Carole S. Mitchell Brakke Schafnitz Ins. Brokers License #OK07568 a7° .310-524-1357 A No :I49-313-3323 SantaWilshire Blvd. # 700 Sanaa Monica, CA 90401 ADDRESS: Carole. mitchell@sig.us INSURER(S) AFFORDING COVERAGE MAIC # Darla Gray INSURERA:Westchester Surplus Lines Ins urrene $ 50,000 PREMISES Ea occcc INSURED Dr. Maureen Sassoon P O BOX 2028 INSURERB: Palos Verdes Peninsula, CA 90274 INSURERC: INSURER D: PERSONAL&ADVINJURY $ 1,000,00 INSURER E: GENERAL AGGREGATE $ 2,000,00 INSURER F: L.LJVVKAL,r_, I_Fw I1FIf .-LIF NI lmmFw. 9 MR1101/ kl L111RaOCO. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDFD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !POLICY LTR TYPE OF INSURANCE IND WVD POLICY NUMBER MMIDDY EFF EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR X Add'Ilnsured X X 624270427005 07!0112017 07/01/2018 EACH OCCURRENCE $ 1,000,000. urrene $ 50,000 PREMISES Ea occcc MED EXP (Any one person) $ 5,000 X Prof & Pollut-CLM PERSONAL&ADVINJURY $ 1,000,00 GEN'LAGGREGATE LIMITAPPLIESPER X POLICY ❑ JecT ElLOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS -COMPIOPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Perperson) $ ANY AUTO ALL OWNED SCHEDULEp AUTOS AUTOS BODILY INJURY Per accident $ ( ) NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE PeraccideM $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ ................. (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Professional L)ab. G24270427005 07101/2017 07/01/2018 Prof.Liab 1,000,00 A Contractors Poll. 624270427005 07/01/2017 07/01/2018 Pollution 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Policy Provides 30 days notice of cancellation except 10 days for nonpayment Applicable Endorsements Attached are Applicable where required by Written Contract. Emailed to: SMorales5@santa-ana.org 111111161z CSANTAA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Briza Morales,Risk Mngr P.O. BOX 19$$ REPRESENTATIVE= Santa Ana, CA 92702 AUTHORIZED REPRES� ©1988-2014 ACORD CORPORATION. All rig isr served. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD q P Named Insured Dr. Maureen Sassoon Endorsement Number Policy Symbd Poky Number Poky Period Effective pate of Endorsement ECP 624270427 006 07/0112017 to 07/0112018 0710112017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number_ The remalnder of the Information is to be completed only when this endorsesneni is issued subsequent to the preparation ofthe poricy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON-CONTRIBUTORY) This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the neniarafinm nG applicable to this endorsement.) SECTION II - WHO IS AN INSURED is amended to include: A. SECTION 11 - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added.- 2. dded: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project C. The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV -3101 (08-04) Includes copyrighted mterial of Insurance Services Office, Inc. with its perp fission V�\V Page i of 1 Named Insured ErtdomementNumbar Dr. Maureen Sassoon Policy Symbol Policy Number Policy Period Et7 CUve Date oiadorsement ECP I G24270427 006 07101!20'17 to 07101/2018 0710112017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the lnfaratatlon Is to be completed only when this andorsement is issued subsequent to the preparation ofthe policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEWNT OWNERS, LESSEES OR CONTRACTORS—SCHEDULED PERSON OR ORGANIZATION This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ENV -3100 (08-04) Includes copyrighted materia[ of insurance Services Office, Inc. with its permission Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number Dr. Maureen Sassoon policy Symbol Polity Number Policy Period Effective Date of Endorsement ECP 624270427 006 07101/2017 to 07/0112018 07101/2017 Issued By (Name of Insurance Company) Westchester Surplus Unes Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PRO IDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organi?ation that is an owner of real property or personal property on which you are perfom-ing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and "included in the products -completed operations hazard. All other terms and conditions remain the sauce. ENV --0220 (10-08) Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT — PRODUCTS -COMPLETED, OPERATIONS HAZARD PRIMARY & NON-CONTRIBUTORY Named Insured Endorsement Number Br. Maureen Sassoon Policy Symbol Policy Number Policy Period Effective Date of Endorsament ECP 624270427 006 07/01/2017 to 07101/2018 07101/2017 Issued By (Name of Insurance company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOV41NG: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement_) Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products -completed operations hazard. Furthermore, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. All other terms and conditions remain the same. ENV -3226 (10-08) V4�� Page 1 of 1 Named Insured Endorsement Number Dr. Maureen Sassoon Policy Symbol Policy Number Policy Period Effective nate of Endorsement ECP 624270427 006 0710112017 to 07/01/2018 07101/2017 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder ofthe information is to be completed only whenthis endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL. LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PANT SCHEDULE Name of Person or O anization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations, i s IIW L711LIy aPNea1a :aUUVe, mioirrration requirea to complete tnls endorsement will be shown in the Declarabons as applicable to this endorsement) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condlf'ton is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in tate products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV -3143 (03-05) Includes copyrighted material of Insurance Services Office, Inc. uvith its permission t IV Page I of 1